Hurricane Season: Maintaining Dialysis Service During Disasters

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The National Oceanic and Atmospheric Administration (NOAA) recently released its storm predictions for 2018: a normal to above normal season with one to four major hurricanes. A day later, the first tropical depression formed in the far west Caribbean followed by tropical storm Alberto in the Gulf of Mexico. We spoke with Bob Loeper, head of disaster preparedness for Fresenius Medical Care North America, as he readies for what might come next.

Fresenius employees volunteer for disaster response duties.Q: When you look back at 2017, what are you most proud of in our response to the multiple hurricanes and wildfires?

BL: It was certainly an unprecedented year with the continuous hurricanes –  Harvey, Irma and Maria. We held disaster response calls daily for about 90 days. What I am most proud of is the way people all over the company stepped up to help out. We asked for volunteers to run command centers, and leaders from all over the company raised their hands to help. We even had some employees, who had emergency management skills from prior employers, volunteer to assist in the efforts, as well as employees who had been in the military or worked for fire departments. They all really made a big difference during this time of crisis.

Q: What were the biggest challenges you faced last year?

Fresenius disaster response teams purchased their own amphibious vehicles for disaster preparedness after hurricane Harvey.

BL: Finding and getting to our patients around Houston and throughout Texas was incredibly challenging. Harvey remained off the coast and just dumped 50 inches of rain over a few days. In the past, we could rely on the Coast Guard or local fire departments to help rescue our patients. But this time the local first responders were overwhelmed. We decided to purchase our own boats and found amphibious vehicles to do our own patient rescues to get our patients to safety and to their dialysis treatments. We had never done that before.

In Puerto Rico, we sent in specialty teams from the mainland who could help our clinics stay up and running. We faced unprecedented power outages along with the lack of fuel for our generators. The first week to 10 days was really touch and go.

Every day we had at least one clinic shut down due to lack of fuel or water. Our patients’ lives depended on our ability to secure diesel and water, and we are proud that we were able to keep our clinics up and running.

Q: What did you learn, and how are you better prepared this year?

BL: Every time we go through a disaster, we get a little better with our response. What we learned from Harvey was how to fine tune the roles within each command center. We bring in incident commanders from outside the region to run the command centers, because the leaders in the affected area are working to just keep clinic operations underway. The incident commanders coordinate deliveries of gas, food, generators and other supplies out to the clinics. Each person in the command center needs to have a specific role, such as who is in charge of tracking down staff, locating patients, finding supplies or even who is going to feed the team. We have a group of eight incident commanders who meet regularly as part of a task force to ensure we are always ready. They are better defining the roles and responsibilities of a command center so this model can be replicated as needed.

Fresenius incident commanders coordinate the delivery of resources for dialysis patients.For Puerto Rico, we realized that when both the landlines and cell phones go down, communication becomes very challenging. We brought in satellite phones for every district operator, but they were difficult to use, had to be outside to get a signal and the receiving party also had to know when to expect a call. This year, we are planning to set up battery-operated ham radios for each area in Puerto Rico and Hawaii. Staff members have volunteered to learn and become licensed operators. We have to be creative to ensure we have communication if something like this ever happens again.

Q: What else is happening right now to be ready for the next storm or other natural disaster?

BL: I just had a call with the corporate disaster response team to go through the roles and responsibilities of every department. We have to be sure we are fully stocked with disaster response equipment in multiple warehouses around the Gulf States. We have drivers lined up who will take our water tankers and generators wherever we need them. When the power goes out, we also do a lot to help our own staff with personal generators, provide gas for their cars, food, scrubs and supplies. Our motto is “if we don’t take care of our staff, we can’t take care of our patients.” That’s something we did really well in previous years and it made a big difference. We will most certainly provide all this support again if needed.

Q: What should patients think about now before a storm is on its way?

BL: One of the most important things patients can do to prepare is to determine where they will go if they have to evacuate and how to preregister for a medical shelter should they be in evacuation zones. Local officials at these shelters often don’t understand the needs of people living with end stage renal disease. Patients need to plan now and know where they are going, how they will get to a medical shelter and what they need to bring. We also like to have additional contact information from our patients for someone who does not live with them to make it easier for us to locate them. Our home dialysis patients need to have three to four weeks of supplies and should be in contact with their local power company to ensure they are first in line for power restoration. A little preparation can go a long way to ensure treatments aren’t missed.

RESOURCES:

Disaster Preparation for patients from Fresenius Kidney Care

Disaster Relief at Fresenius Medical Care

Fresenius Medical Care North America: How We Respond to Disasters